Challenges on commodity management at Facility Level: Experience from Baylor Center of Excellence, Mbeya

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1 Challenges on commodity management at Facility Level: Experience from Baylor Center of Excellence, Mbeya Nadiya A. Jiwa, B. Pharm., MSc. HPM Stakeholders meeting for HIV/AIDS commodities, Rukwa Overview About Baylor COE Process of Procuring and Dispensing Hurdles in Commodity Management Stroke of Luck Recommendations Food for thought 1

2 Baylor International Pediatric AIDS Initiative (BIPAI) Established 1996 Committed to improving the health and lives of HIV-infected children and families globally Currently active in Romania and across Africa BIPAI Children s Clinical Centers of Excellence Network Established January, 2004 with opening of a 2 nd clinic in Botswana Mission: High quality, high impact, highly ethical pediatric and family HIV/AIDS care and treatment, health professional training and clinical research Designed to catalyze pediatric HIV/AIDS care and treatment globally 2

3 The BIPAI Children s Clinical Centers of Excellence Network Performance Zones and Host Institutions MWANZA - Lake Zone Host Institution: Bugando Medical Centre (BMC) MBEYA Southern Highlands Zone Host Institution: Mbeya Referral Hospital (MRH) DAR ES SALAAM Coordination Office 3

4 2010 Baylor College of Medicine 2010 Baylor College of Medicine 4

5 2010 Baylor College of Medicine 5

6 2010 Baylor College of Medicine Baylor-Tanzania: Overall Goal & Objectives GOAL: To contribute to the reduction of HIV/ AIDS-related morbidity and mortality among infants, children and adolescents in Tanzania Aim 1: Comprehensive Pediatric HIV Care Aim 2: Enhanced Pediatric HIV Case Finding Aim 3: Health worker and Health System capacity building Aim 4: Community Sensitization and Mobilization in Support of Pediatric HIV Prevention, Care and Treatment Service 6

7 Process of Procurement and Dispensing Needs Estimation of prospective commodity needs Witi Writing of requisition iti order Receiving Getting approval from MRH for order delivered Counter-checking and receiving from Central Store Registering Inserting stock details in bin-cards and expiry alert chart Noting expiry dates related with quantity for each commodity Dispensing Dispensing each medication according to dosage and appointment date Data entry Entering each quantity dispensed from prescriptions into daily dispensing excel sheet Hurdles in Commodity Management Increasing number of patients at irregular rate Receiving medicines with very near expiry dates (3TC and AZT syrups) Change of ART guidelines (PMTCT) Increasing numbers of second-line ART 7

8 Hurdles in Commodity Management Availability of new formulations of ART Shortage of prescription food (RUTF/FBF), ART and Ois Changes in funding for OIs Errors leading to inappropriate p forecasting Disposal of expired/damaged medicines 8

9 Stroke of Luck: Cooperative teams at MSD/SCMS, MRH and outreach sites Provision of Outreach services and training peer providers Availability of good recording systems and trainers Well qualified pediatricians for care and welfare of children living with HIV/AIDS Competent and standardized system for healthcare delivery internationally Recommendations: Monthly meetings with stakeholders involved in process (MRH, MSD and Baylor) Frequent and pro-active alerts of possible stockouts Visits to/from MSD to understand availability of old and new ARV Knowledge sharing sessions for pharmacists 9

10 Knowledge Sharing for Pharmacists: Food for thought: What criteria are considered for selection of preferred ART regimen? Thank you! "...intellectuals have a special contribution to make to the development of our nation, and to Africa. And I am asking that their knowledge, and the greater understanding that they should possess, should be used for the benefit of the society of which we are all members." Julius Kambarage Nyerere, from his book Uhuru na Maendeleo (Freedom and Development),